Am J Trop Med Hyg 2019 Jun;100(6):1498-1506
Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, United Kingdom.
Using the 20-meter shuttle run test (20mSRT) as a morbidity metric, we assessed whether infection was associated with decreased aerobic capacity in Ugandan children across a range of altitudes, either at low (∼600 m) or high (∼1,000 m) altitudes. A total of 305 children were recruited from six schools within the Buliisa District, Lake Albert, Uganda. A subset ( = 96) of these had been previously assessed and treated for schistosomiasis ± malaria 2 weeks prior. Fitness scores on the 20mSRT were translated into VO2max using a standardized equation. Unadjusted and multivariable-adjusted analyses were performed using VO2max as the primary outcome. Analysis of fitness scores from 304 children, inclusive of the subset follow-up cohort, revealed a median VO2max of 45.4 mL kg min (interquartile range: 42.9-48.0 mL kg min). Children residing at high altitudes demonstrated increased aerobic capacities (46.3 versus 44.8 mL kg min, = 0.031). The prevalence of stunting, wasting, egg patent infection, malaria, giardiasis, anemia, and fecal occult blood were 36.7%, 16.1%, 44.3%, 65.2%, 21.4%, 50.6%, and 41.2%, respectively. Median VO2max was elevated in those previously treated, compared with those newly recruited (46.3 versus 44 mL kg min, < 0.001). Multivariable-adjusted analysis revealed a strong negative association between egg patent infection and VO2max at low altitude (beta coefficient: -3.96, 95% CI: -6.56 to -137, = 0.004). This is the first study to document a negative association between infection and aerobic capacity at low altitudes using the 20mSRT.